重症监护病房患者导管相关性医院感染的预后分析  

Statistical analysis of catheter-associated nosocomial infections in ICU patients

作　　者：张莉[1] 张淑林[2] 李花[1] 景秀英 

机构地区：[1]陕西中医药大学第二附属医院重症医学科,咸阳712000 [2]陕西中医药大学第二附属医院护理工作部,咸阳712000

出　　处：《山西医药杂志》2017年第15期1805-1807,共3页Shanxi Medical Journal

基　　金：陕西省教育厅科研项目(15JK1214)

摘　　要：目的评估重症监护病房(ICU)患者导管相关性医院感染的发生情况。方法以480例符合条件的ICU患者为研究对象,前瞻性地观察导管留置情况、导管相关性医院感染的发生情况,并对监测数据进行统计分析。结果 480例留置导管的ICU患者中,121例出现导管相关性医院感染,感染率为25.2%。最常见的感染是导尿管相关性医院感染(51.7%)。193例气管插管患者发生44例次感染,例次感染率为22.8%;410例导尿患者发生79例次感染,例次感染率为19.2%;370例中心静脉置管患者发生30例次感染,例次感染率为8.1%。气管插管的医院感染发生率最高,为10.4‰。留置不同数量导管患者相比,例次感染率差异有统计学意义(χ2=33.540,P<0.01)。结论 ICU患者发生导管相关性医院感染的概率较高,其中最为常见的是导尿管相关性医院感染。且使用导管数量越多,其感染发生率越高。严格控制导管留置指证、加强导管尤其是导尿管及气管插管的护理是减少ICU导管相关性医院感染的关键。Objective To assess the incidence of catheter-associated nosocomial infections in ICU patients.Methods A total of 480 eligible ICU patients were enrolled in this study.The incidence of catheterization and catheter-related nosocomial infection were prospectively observed and the data were analyzed statistically.Results Among 480 ICU patients indwelling catheters,121 patients had catheter-related infection,the infection rate was25.2%.The most common infections was catheter related nosocomial infection（51.7%）.Forty-four case-time infections occurred in 193 cases of intubation patients,with a rate of 22.8%;79 case-time infections occurred in 410 cases of catheterization patients,with a rate of 19.2%;30case-timeinfections occurred in 370 patients with indwelling central venous catheter,with a rate of 8.1%.Intubation patients had a highest incidence of nosocomial infections,with a rate of 10.4‰.The case-time infection rate was significantly different among patients with indwelling different number of catheters（χ2=33.540,P〈0.001）.Conclusion ICU patients are prone to catheterassociated nosocomial infections,and catheter related infection is an important component.The more ducts patients indwell,the higher infection incidence patients have,especially catheters and endotracheal catheters related infections.Strict control of catheterization and strengthened care of catheters and endotracheal intubation is the key to reducing catheter-related nosocomial infections in ICU.

关 键 词：重症监护病房 交叉感染 插管法 气管内 导尿管插入术 

分 类 号：R473[医药卫生—护理学]